急性缺血性脑卒中患者红细胞分布宽度与出血性转化及预后的关系

Relationship between red blood cell distribution width on one hand and hemorrhagic transformation and prognosis on the other in patients with acute ischemic stroke

目的探讨急性缺血性脑卒中患者红细胞分布宽度(red blood cell distribution width,RDW)与出血性转化及预后的关系。方法选取2018年1月至2020年2月就诊于本院的128例急性缺血性脑卒中患者为观察组[观察1组(RDW≤15%)37例,观察2组(RDW>15%)91例],60例健康体检者为对照组。对比两组实验室指标差异,并分析不同RDW水平组入院时、出院时实验室指标、神经功能缺损情况以及并发症发生情况。结果观察组RDW、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)高于对照组,差异有统计学意义(均P<0.05)。入院时,观察2组Hcy、hs-CRP高于观察1组,差异有统计学意义(均P<0.05);两组美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力评分(ADL)相比,差异无统计学意义(均P>0.05)。出院时,两组NIHSS评分、Hcy、hs-CRP、ADL评分较入院时明显改善,而观察2组NIHSS评分、Hcy、hs-CRP高于观察1组,ADL评分低于观察1组,差异有统计学意义(均P<0.05)。观察2组出血性转化率高于观察1组,差异有统计学意义(P<0.05)。两组多器官功能障碍综合征发生率对比,差异无统计学意义(P>0.05)。结论急性缺血性脑卒中机体RDW水平较高,且RDW水平越高者Hcy、hs-CRP越高,出血性转化发生率越高,预后越差。

Objective To investigate the relationship between red blood cell distribution width(RDW)on one hand and hemorrhagic transformation and prognosis on the other in patients with acute ischemic stroke.Methods A total of 128 patients with acute ischemic stroke treated at our hospital from January,2018 to February,2020 were selected as an observation group[observation groupⅠ(RDW≤15%)with 37 cases and observation groupⅡ(RDW>15%)with 91 cases],and 60 healthy subjects a control group.The differences in laboratory indicators between the two groups were compared.The laboratory indicators,neurological deficits,and complications of the different RDW level groups at admission and discharge were analyzed.Results The RDW and levels of homocysteine(Hcy)and high-sensitivity C-reactive protein(hs-CRP)of the observation group were higher than those of the control group,with statistical differences(all P<0.05).At admission,the levels of Hcy and hs-CRP were higher in the observation groupⅡthan in the observation groupⅠ(both P<0.05);and there were no statistical differences in the scores of the National Institutes of Health Stroke Scale(NIHSS)and the ability of daily living(ADL)between the two groups(both P>0.05).At discharge,the NIHSS score,Hcy,hs-CRP,and ADL score were significantly better than those at admission in both groups;and the NIHSS score,Hcy,and hs-CRP were higher and the ADL score was lower in the observation groupⅡthan in the observation groupⅠ(all P<0.05).The hemorrhagic transformation rate was higher in the observation groupⅡthan in the observation groupⅠ(P<0.05);there was no statistical difference in the incidence of multiple organ dysfunction syndrome between the two groups(P>0.05).Conclusion The RDW of patients with acute ischemic stroke is high;the higher the RDW level,the higher the Hcy,hs-CRP,and the incidence of hemorrhagic transformation and the worse the prognosis.